@article{oai:ir.kagoshima-u.ac.jp:00005301,
 author = {新地, 洋之 and SHINCHI, Hiroyuki and 高尾, 尊身 and TAKAO, Sonshin and 前村, 公成 and MAEMURA, Kosei and 又木, 雄弘 and MATAKI, Yuko and 蔵原, 弘 and KURAHARA, Hiroshi and 桑畑, 太作 and KUWAHATA, Taisaku and 川崎, 洋太 and KAWASAKI, Yota and 南, 幸次 and MINAMI, Koji and 飯野, 聡 and IINO, Satoshi and 迫田, 雅彦 and SAKODA, Masahiko and 上野, 真一 and UENO, Shinichi and 石神, 純也 and ISHIGAMI, Sumiya and 夏越, 祥次 and NATSUGOE, Shoji},
 issue = {1-2},
 journal = {鹿児島大学医学雑誌, Medical journal of Kagoshima University},
 month = {Sep},
 note = {Background and Purpose: Pancreatic anastomotic leak remains a persistent problem after pancreaticoduodenectomy.
The presence of soft, nonfibrotic pancreatic tissue is one of the most important risk factors for pancreatic leak. Accordingly,
we devised a pancreas-transfixing suture method for pancreaticogastrostomies in patients with a soft, nonfibrotic pancreatic
remnant., Methods: As for the pancreaticogastrostomy technique, an ultrasonically activated scalpel was used for transecting the
pancreas. The inner layer involves a duct-to-mucosa anastomosis with an internal stent and the outer layer involves a single
row pancreas-transfixing sutures between the pancreatic remnant and the posterior gastric wall., Results: A total of 228 consecutive patients underwent pancreaticoduodenectomy with pancreaticogastrostomy. Of
the 228 study patients, 154 patients (67%) had a soft pancreas. There was no operative or hospital death. Postoperative
complications occurred in 38 patients (17%). Pancreatic fistula (Grade B/C) occurred in 4 patients (1.8%) with a soft thin
pancreas. These pancreatic leaks were managed nonoperatively by maintaining the closed drains.
Conclusion: This technique is simple and appears to reduce the risk of pancreatic leakage possibly by decreasing the
risk of suture injury of the pancreas and by embedding the transected stump into the wall of the stomach. This novel
pancreaticogastrostomy can be recommended as an effective reconstructive procedure, especially for patients with a soft,
nonfibrotic pancreas.},
 pages = {1--7},
 title = {膵頭十二指腸切除術における膵消化管吻合の手術手技 : 安全確実な膵胃密着吻合法},
 volume = {64},
 year = {2012}
}